{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" M AVANELLA","gend":1,"add":"       DAOR EGDIR DLO 914                         ","city":"FARMVILLE                ","state":"VA","zip":"23901-9998","dob":"1980-01-17","age":"","mstatus":"","insh":"10112763","cliId":"","pno":"9343440642","cno":"","email":"","ename":"","eno":"","pphy":"HAHESY-CALHOUN, MARIAN A","ppno":4345425560,"pcpadd":"165 LEGRANDE AVE,PO BOX 470","pcpcity":"Charlotte Court House","pcpstate":"VA","pcpzip":239233747,"pcpcounty":"","pcpid":"","pcpname":"CHARLOTTE PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"419 OLD RIDGE ROAD                                ","madd2":"                                                  ","madd3":"","mcity":"FARMVILLE                ","mstate":"VA","mzip":"23901-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","Z13.1","I10","Z71.89","Z71.3","E78.2","N92.1","Z32.02","R10.11","M65.322","Z13.220","Z11.4","Z11.59","R30.0","N30.00","J45.909","F33.1","Z01.30","D50.8","E66.9","N92.0","D25.1","Z12.31","N91.1","N92.6","Z01.419","F33.40","J45.20","J40","R05.9","R11.0"," ","Z01.411","N93.9","L68.0"],"date":["2022-12-01","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2020-08-25","2022-11-28","2020-08-07","2020-08-07","2020-08-07","2020-08-07","2020-08-07","2022-05-31","2022-05-31","2022-11-23","2022-05-31","2022-11-23","2022-05-31","2020-12-29","2020-09-11","2020-09-11","2022-11-28","2021-06-09","2021-06-11","2021-08-03","2022-11-23","2021-11-23","2022-09-17","2022-09-17","2022-11-23","2022-12-01","2022-11-28","2022-11-28","2022-11-28"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","69918030130","TRANEX","TAB 650MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00093834410","GLYBURIDE","TAB 5MG","30","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","30","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","00169431413","RYBELSUS","TAB 14MG","90","Select","Select",""],["","65862037405","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00597015290","JARDIANCE","TAB 10MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68180046707","LOVASTATIN","TAB 10MG","90","Select","Select",""],["","68180016106","AZITHROMYCIN","TAB 500MG","5","Select","Select",""],["","00054032756","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","56151149002","TRUE","KIT AIR","1","Select","Select",""],["","555077902","MEDROXYPR","TAB 10MG","10","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}